Modern Maturity Center

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

MODERN MATURITY CENTER

Practice address

1125 Forrest Ave
Dover, DE 19904

Phone

(302) 734-1200

Fax

(302) 346-5340

NPI assigned

Jan 4, 2007

Last updated

Jan 13, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carolyn Fredricks

Title

President/Ceo

Phone

(302) 734-1200

Specialties & licenses 3

Addresses

Locations

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Cedric Terriell Barnes, D.O.

  • Family Medicine Physician
  • Milford, DE
  • NPI 1851338040
  NPD (past)
• Cristina L. Bonilla-Cooke, PA-C

  • Physician Assistant
  • Newark, DE
  • NPI 1003897216
  NPD (past)
• Steven Cain, P.A.-C

  • Physician Assistant
  • Dover, DE
  • NPI 1649296591
  NPD (past)
• Josefina Luisa Cancino, MD

  • Family Medicine Physician
  • Middletown, DE
  • NPI 1154404143
  NPD (past)
• Robert Chrzanowski, M.D., FACEP

  • Emergency Medicine Physician
  • Dover, DE
  • NPI 1598781445
  NPD (past)
• Stacey Lynn Cronauer, PA-C

  • Physician Assistant
  • Dover, DE
  • NPI 1659362689
  NPD (past)
• David Ross Davenport Jr., PA

  • Physician Assistant
  • Dover, DE
  • NPI 1518981539
  NPD (past)
• Ralph Joseph Defriece, M.D.

  • Family Medicine Physician
  • Millville, DE
  • NPI 1760473789
  NPD (past)
• Priyanka Dixit-Patel, MD

  • Family Medicine Physician
  • Smyrna, DE
  • NPI 1760536262
  NPD (past)
• Mhaidi Elmedkhar, M.D.

  • Family Medicine Physician
  • Middletown, DE
  • NPI 1760461859
  NPD (past)
• Aaron Green, M.D.

  • Occupational Medicine Physician
  • Millsboro, DE
  • NPI 1386635563
  NPD (past)
• Patricia J Jacob, FNP

  • Family Nurse Practitioner
  • Smyrna, DE
  • NPI 1982685038
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673568000000",
    "number": "1609923408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 FORREST AVE",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199043308",
            "telephone_number": "302-734-1200",
            "fax_number": "302-674-1265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 FORREST AVE",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "19904",
            "telephone_number": "302-734-1200",
            "fax_number": "302-346-5340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN MATURITY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A",
        "authorized_official_last_name": "FREDRICKS",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "302-734-1200"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "DE",
            "license": "ADC-001",
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Camille Mitchell
• Swagata Mitra, M.D.
• Jad Mitri, MD
• MLK Jr Educational Community Center, Inc
• Mobileyes
• Michael James Moeller, D.D.S.
• Jamilah Mogharbel
• Ahmed Mohfouz, M.D.
• Jesse Mohoric, PT
• Patricia Moise, LMFT

• Adult Day Care Clinic/Center in Dover, DE
• Providers in Dover, DE by specialty
• Adult Day Care Clinic/Center in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.